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their officers. The latter question is one for even more seriousconsideration than the former’, for it would clearly be futileto amend organisation if it gave no security for an amendedadministration. It can scarcely be doubted that a greatnumber of the new sanitary authorities appointed in 1872are performing their functions in a most perfunctory mannerat the best, and that the local rates and imperial exchequerare saddled with costs in these districts for which there is no

proper return. It will be idle to have recourse to legislationwith a view of abating this evil until it is known whether

it has its sources in matters which legislation will touch.Some part of the evil it is known has its origin in the actionof the Local Government Board when under the presidencyof Mr. STANSFELD, and there is no good reason to supposethat this would be affected by legislation. As a preliminarystep to further general sanitary legislation, we believe it tobe essential, if the legislation is to be other than a furthersource of confusion, that a Parliamentary inquiry should beinstituted as to the working of the Public Health Act,1872. Until this has been done we feel assured that

Parliament will approach the subject in the dark, and thatfurther legislation will lead to further confusion in our

sanitary administration.

Annotations." Ne quid nimis."

THE ADMISSION OF WOMEN TO THEUNIVERSiTY OF LONDON.

A CORRESPONDENT of The Timcs has this week pointedout, as we have frequently done, that it is really the desireto admit women to the medical profession which has

prompted the whole question of the higher education ofwomen and their admission to the degrees of the Universityof London. He alludes to the significant fact that theSenate had refused its University honours to women untilthe Russell-Gurney Act was passed, when it at once con-ceded to women the privilege of practising medicine. These

words, indeed, touch a vital question, which neither theSenate, in all its arguments, nor Convocation, has endea-voured to controvert. The Chancellor, in that " circular" "

which gave such an impetus to his cause, but which excited,even amongst moderate men of all sides, no little pain,stated that the Russell-Gurney Act was adopted so hastilybecause the Medical Faculty seemed to demand immediatereform in the direction of admitting women ; but this lameexcuse cannot blind any but enthusiasts. The Chancellor

forgot to explain that-to use his own words-Convocationhad "repeatedly voted for the admission of women to thedegrees of the University," so that the Senate might longago have asked for the new charter ; and, further, to explainthat all senators who were prepared to adopt the Russell-Gurney Act were not in favour of the new charter-in fact,that some of these had voted against it. There can be no

question that the opening of the University degrees is a

special legislation-in reality, concerning only the medicalprofession. The University degree in Laws will give womenno right to act as barristers or solicitors ; but the severallegal gentlemen who supported the new charter with suchvehemence never alluded to this fact, and have never byword or deed agitated to break down the barriers whictkeep women from the legal profession. It may well bE

asked, then, why the medical graduates are taunted abov(all others as wanting in a "liberal spirit." We do n01

charge any section of graduates with acting from the motivesimputed unfairly to the medical graduates, but we do thinkthat many who voted for the new charter did so withoutgiving the whole question a thorough consideration.

The vote, which, if acted upon, will reduce the Universityof London to a mere licensing body from the high position ithas hitherto held, concerns not only the University, which,we fear, will have to pay a heavy penalty for its new policy,but the whole medical profession and the whole public.There cannot be t doubt that the profession, by a largemajority, condemns the encouragement of women in a line ofstudy which, no matter what enthusiasts may advance, is cal-culated, when pursued by women, to demoralise the country.The step recommended by the University of London will, if car-ried out, disturb the groundwork of our social life, and teachmen to regard women with less reverence than has always cha-racterised this and all other countries of any pretensions tobe considered civilised. We will not dwell on the repug-nant work which awaits all female candidates for the London

University’s qualification to practise medicine. " Thewomen want to be doctors, so let them be doctors," is oneof the strongest arguments advanced in favour of their pur-suing this work-an argument as foolish as it is fallacious,and one we need not discuss. Another equally extraordinaryargument was used in Convocation, " The time has come forsettling this controversy, so, though we doubt its good, letus vote for the new charter."We mention these things because, though we have not

seen the division-list of Convocation, we know that " sideissues," which one speaker so strongly deprecated, were notkept out of the question, but really played an overwhelmingpart. Thus graduates totally opposed to the admission ofwomen voted for the charter for the sake of "peace";others who had their " doubts " voted for it; and there canbe no doubt that Lord Granville’s circular brought to Con-vocation a number of men never before seen there, and whovoted in accordance with that circular, but had givenno consideration to the question. It should not be forgottenthat nearly three hundred graduates protested in May lastagainst the admission of women to medical degrees, thesebelonging to the medical faculty alone, and that the majorityin Convocation which carried the new charter included only242, the minority being 132. Thus it is clear that this vote,strong though it apparently was, cannot justly be consideredto represent the views of Convocation. The vast majorityof graduates cannot attend meetings of Convocation, andthey are de1arrec1 the right of voting by proxy, even on suchimportant questions as the surrender of the Universitycharter. Who will cteclare that the vote might not have beendifferent from tlae one we regret had all members of Convoca-tion been able to share ill it In any case no one will disputethat in this direction, at least, there is room for "reform"

"

.

in the University. -

VICTOR EMANUEL AND BLOODLETTING.

FROM time to time the details of the fatal illness of someeminent person in Italy call public attention to the mainte-nance there of the practice of venesection in acute febrilediseases. The system has been uniformly abandoned in

every other country which can be considered to have sharedin the progress of medical science and practice that hasmarked the last twenty years. In Italy it is retained withpertinacity, even-as the latest example shows-in thehighest, and presumably the best informed, circle of medicalpractice. Can the practice be justified by any special featureof Italian pyrexia ? The system is applied equally to nativesand to strangers, and therefore cannot be regarded as indi-cated by the constitutional state of the individual. An

English-traveller who becomes ill in an Italian town is bled, toa certainty, if lie is febrile. We doubt profoundly if there is

136

any justification for the practice in the character of the Italian and proclivities than the incapacity of advanced mentalfever. Venesection is advocated on the grounds which were disease. In the earlier stages of epileptic and paralyticheld to justify the retention of the practice in this country, affections we are inclined to think the law has a dis-

and were universally recognised as fallacious as soon as the tinct and reasonable claim upon the obedience of these

advantages of its abandonment were seen. There can be little so-called "lunatics," and such discipline as they may re-doubt that in Italy at the present day venesection is re- ceive in a well-conducted penal establishment will be

sponsible for a great number of the deaths from acute febrile helpful instead of injurious. What is so much needed is

diseases. But to what extent the death of the late King is not that cases of this class should be sent to asylums ratherto be attributed to the abstraction of blood is a doubtful than to prisons, but that every medical officer in the publicquestion. It is certain that in this country he would not service should be able to bring special knowledge of mentalhave been bled. It can hardly be doubted that the vene- disease to bearupon the proper management of their individualsection was wholly without influence for good, and it is pos- conditions, and to apply the required principles of "moralsible that it aggravated the disease. But we are informed treatment " to their relief. It would, we think, be an evilthat the amount of blood removed was small, not large, as of no small magnitude if the plea of insanity were set upsome of our contemporaries have asserted, and the progress without due reason, or on sentimental grounds. The greatof the disease was so rapid, the attack so severe, that it want of the day is a medical tribunal to decide these ques-is probable, under any circumstances, the King must have tions before the case is arraigned at a legal bar. By such asuccumbed. The question of the utility of venesection is one tribunal medical evidence would be submitted to tests in-of great importance for the Italian faculty. It leads to the comparably more severe than any which can be applied by auniversal distrust by foreigners of Italian physicians, who are lay judge or an unskilled jury, however intelligent andnot otherwise, as a rule, ill-informed. painstaking.

EPILEPSY AND "RESPONSIBILITY." THE PUBLIC HEALTH (IRELAND) BILL, 1877.

IT is of the greatest moment that the relations of epilepsy ON the 9th inst. a deputation from the Public Healthand insanity-or that condition of mind which gives immunity Committee of the Corporation of Dublin had an interviewfrom the obligation of answering for the actions performed, with the Chief Secretary of Ireland for the purpose of

presumably, in obedience to the will—should be clearly under- drawing his attention to various amendments which theystood. A case, involving a nice question of personal re- believed will be of benefit in the Public Health (Ireland)sponsibility, has just engaged the attention of the Court of Bill, which is to be reintroduced this session. Mr. Gray,Assize at Cambridge. ’A letter-sorter was charged with M.P., chairman of the committee, referred to the high death-abstracting letters from the mail. He had accumulated a rate of Dublin, and said that the committee thought thatconsiderable quantity of valuables which lie does not appear there should be only one central authority empowered to dealto have appropriated to his use or benefit, and this circum- with sanitary matters. There should also be power to levystance was relied upon to support the theory that he was not a in the city a distinct rate for sanitary purposes, instead ofcommon thief, but the victim of disease. A history of epilepsy, trying to defray the expense out of the borough fund.

though the fits were not numerous, seems to have given Suggestions were made about sewers and drains, the com-support to the hypothesis raised. We are not prepared to mittee desiring that power should be given to deal withassert that the criminal in this case was irresponsible, and them, to regulate the construction of new buildings, and theas he has been sentenced to penal servitude for five management of slaughter-houses. It was pointed out thatyears, it is probable that he will be kept under observation Clause 144 of the Bill provided a penalty against any personlong enough to determine the facts of his condition with- "showing for the purpose of letting " any house in whichout inflicting any irreparable injury upon the individual. there had been infectious disease, provided that the personNevertheless, the question involved is one of surpassing who was negotiating asked a question on the subject. Theinterest. It does not seem to be sufficiently well known, Committee thought that the Bill should go further, andparticularly on the judicial bench, and at the bar, that even make it incumbent upon the person seeking to let a house inslight seizures of the epileptic type gradually, but certainly, which there had been infectious disease to give notice of theundermine the judgment or will, and leave the mind a prey fact. They also considered that the owners of all classes ofto those brute passions which man possesses in common with lodging-houses, including hotels, in which dangerous dis-the lower animals. It would appear that, under the influ- orders broke out, should be compelled to give notice of theence of this terrible malady, the higher faculty of self-control fact to the sanitary officer. Clause 114 provided a penaltyis suspended, and the victim becomes less than human. We against any person who " knowingly " sent a child to schoolhave repeatedly insisted that it is the least well developed for a certain period after it had suffered from any infectiousfaculty which falls first before the paralysing invasion of disorder. The word "negligently

"

might with ad-disease. This consideration has a direct practical bearing vantage be substituted for "knowingly," because it wouldupon the question of "responsibility," and cannot be be very difficult to prove knowledge. The maximum

wholly overlooked in the judicial view. If a man penalty of 40s. for such an offence ought to be increased toreduces himself by neglect or vice to the condition ;E20, in order that poor and rich might be dealt with accord-of an incapable being, whether the paralysing agent ing to their means. Conductors of schools, also, should bebe disease or a drug that intoxicates, he cannot, in the obliged to give notice of the outbreak of dangerous disordersinterests of society, be allowed to plead temporary uncon- in their schools. Clause 146 imposed a penalty for neglectsciousness as an excuse for what may follow. He is respon- of vaccination, but the Committee thought that there shouldsible for the cause, if not for the result. We should not of be power to impose cumulative penalties for repeatedcourse hold that a confirmed epileptic is accountable, but we refusals to vaccinate. They also recommended the intro-are not able to say that, in our judgment, a man or woman is duction of a clause prohibiting wakes. Sir Michael Hicks-

irresponsible because he or she happens to have occasional Beach, in reply, said that last year he was obliged to with-fits. There may be progressive depravity of the moral sense, draw the Bill, after it had been carefully considered by abut, for practical purposes, it must be remembered that this Select Committee, on the understanding that the measurelowering of the instinct of judgment and self-control-and should be reintroduced this session precisely as it was left-blunting of the sense of right and wrong—is of -a nature that is, that it should be allowed to pass to the same stageanalogous rather to the depravity of vulgar and vicious tastes which it had occupied when it was withdrawn, and that then

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any further amendments which might appear to be necessary scientific too. To obviate the necessity of abandon-should be discussed. He therefore felt himself precluded ing popular phraseology, both accuracy and precisionfrom reintroducing the Bill in any shape different from that are sacrificed. A strict analogy is said to exist between thein which it emerged from the Select Committee ; but world of sound and the world of light. There is, of course,between the reintroduction of the measure, and the date at some analogy between colour and musical-pitch, inasmuchwhich discussion would take place, there would be ample as differences between colours, like differences betweentime for him to consider the various suggestions that had musical-pitch, depend on difference in the length and fre-been made.

____ quency of their respective vibrations, but in almost everydetail the relation between colours is widely different from

THE INCREASED METROPOLITAN DEATH-RATE. the relation between sounds. Nor is it strictly correct to sayDURING the first three weeks of this year the annual

that of an imagined or rather imaginable compound sounddeath-rate in London averaged 27-0 per 1000, whereas composed of notes of all possible pitch we have an exactin the nineteen large provincial towns also dealt with equivalent in the case of white light, which gives a con-in the Registrar-General’s Weekly Return, the death- tinuous spectnm. As another illustration of one of the evils

rate did not average more than 24-7 per 1000. The attending attempts to make popular science attractive, werate in London is so usually below the average rate quote the following peroration to a description of the spectro-in the nineteen provincial towns, which have an aggre- scope :-" Here, indeed, we are in the presence of a new

gate population almost equal to that of London, that mllsic of the spheres, to which our eyes are rapidly becomingit is worth noting a few of the main features of the recent attuned. As in the old one, cycle on epicycle, orb on orb,’excessive metropolitan rate. In the week ending the are still the vibrating chords in the heavenly chorus ; but19th instant, the 1903 deaths registered in London exceeded the cycle is the cycle of the atom, and the orbs are no longerthe corrected average number for the corresponding week distant suns dwarfing our imaginations by their vastness,in the last ten years by 215, and were equal to an

but the ultimate molecules of matter." Grandiloquent, butannual rate of 27’ per 1000, a higher rate than had prevailed not scientific !

--

in any week since the beginning of April last. The deathsfrom all causes exceeded the average by 21 per cent., and MEDICAL EXAMINATIONS FOR LEGAL

while the deaths referred to diseases of the respiratory organs PURPOSES.

showed an excess of 42 per cent., the excess from all other A CASE before Mr. Justice Denman, at Manchester, oncauses of death was not more than 14 per cent. The low the 21st inst., is important as showing that the law is nottemperature which prevailed during the week ending the well defined with respect to the liability of medical practi-12th instant thus appears to be mainly responsible for the tioners instructed to examine patients for legal purposes.increased death-rate in London, although the fatal preva- The complainant in this case was a woman who had beenlence of small-pox, measles, and whooping-cough, and an charged with having abandoned her infant a few hours afterunusual number of deaths from different forms of violence, its birth. The practitioner called in was, at the instigationcontributed to swell the excess. During November and of the " Vigilance Association for the Defence of the Per-December the death-rate in London was unusually low, and sonal Rights of Women and Children "-an organisation de-many persons in indifferent health survived, who would have signed to oppose the working of the Contagious Diseases.succumbed to more usual and seasonable weather. The Acts, - proceeded against for examining the complainantmoderately cold weather of the second week of January, against her will. It was alleged that she was forcibly held.probably, therefore, only claimed for victims a proportion of The evidence did not support the theory of coercion, butthose whose lives had been prolonged by the preceding mild pointed to consent, and the jury found for the defendant.weather. In the face of these exceptional fluctuations it is Nevertheless, the legal ruling of Mr. Justice Denman goessatisfactory to bear in mind that, whereas the death-rate in to prove that no medical man may suppose himself armedLondon averaged 24’4 per 1000 during the six years 1865-70, with authority to proceed contrary to the express willit decreased to 22’9 in the following six years 1871-6; while of the person he is instructed to examine. Personalin 1877 the rate did not exceed 21-9 per 1000. While small- rights" are superior to the power of a court of magistracy !pox epidemics and the unduly fatal prevalence of measles and We wonder whether the authorities of prisons have anywhooping-cough still afford evidence of defective sanitary legal right to photograph prisoners ? It is time these dis-

organisation, sanitary progress in London ig an undeniable crepancies of law and " order" were adjusted. As the matterfact. now stands, grave scandals may arise, and medical men may

-

be placed in an extremely painful predicament, by too con-EARS AND EYES. fidingly assuming that the order of a justice is clothed with

IT has always been a question with many thoughtful per- an authority it does not possess. He may be cast in an

sons whether evil or good is likely to preponderate from action for doing his duty, or be committed for contempt ofpopularising natural science. An article by Mr. Norman court if he omits it.

____

Lockyer in the current number of Macmillan’s Magazine, on"Ears and Eyes," contains most of the merits, with not a ADVERTISING DOCTORS.

few of the faults, of popular expositions of abstruse scientific WE fear there is a growing indelicacy which permitstruths. The technicalities of physical and physiological medical men in one form or another to advertise their skill,acoustics and optics are aptly overcome oy the employment and even their drugs. It is lamentable to see the variousof familiar terms and happy similes, but at the price of forms which this advertising system takes. Sometimes theoccasional looseness and even inaccuracy of expression. The advertisement appears in quite the ordinary form, in a news-extreme simplicity of many of Mr. Lockyer’s illustrations paper. We have two or three specimens before us as we

shows that he understands his readers, and knows what they write. Some of them are colonial. " Dr. So and So mayberequire. But he sometimes indulges them too far. consulted daily at Mr. So-and-So’s, chemist. AdviceThe parallelism traced between sound and light is eighteen pence ; medicine eighteen pence." The advertiserinstructive up to a certain point; beyond this its em- boasts of being L.R.C.P. and L.R.C.S. of Edinburgh. "Mr.ployment is misleading. And here the danger mani- John -, surgeon, London and Edinburgh Royal Colleges.fests itself of attempting to teach the higher truths of Hours of consultation 10 to 12 A.M., 2 to 4, and from 7 to 8.science to non-scientific persons, who are often un- Intermediate hours devoted to visiting practice." There is a

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fine vagueness, bythe way, in the statement about the colleges cheap, and, at the distinct cost of losing, or, rather, byhere. But that is no disadvantage in an advertisement. We deliberately giving up, an ungenerous patient now and again,have said some of the specimens are colonial. But some of to assert that medical care and skill must be paid for.them are not. Here is a specimen from a country newspaper : ————

"We understand that Dr. -, senior physician to the - THE PHYSIOLOGY OF THE PANCREAS.here, is practising as a consulting physician. 934." The figures A PAPER appears on this subject by MM. Afanassiew andare a mystery, but may have some reference to the folio of Pawlow, in the last part of Pffüger’s Archiv, m which theythe ledger of the newspaper in which the worthy doctor is discuss the advantages of permanent as compared withdebited to the extent of a few shillings in consideration of temporary nstuhc, awarding the palm to the former; and

this "We understand. If he repeats the advertisement, having decided this, they set themselves to ascertain theas no doubt he will not he should pay a little more to have innervation of the pancreas. From analogy this gland mightthe figures omitted. The advertisement would then read either receive special excitory nerves, or its secretory activitymore like an independent paragraph showing some public might be regulated by the vaso-motor system, or both setsinterest in the doctors mode of practice. At present it has of fibres might cooxist. The existence of a vaso-motorthe mark of a thing paid for, and which would never be the system of nerves is indubitable; it remained to demonstratesubject of a newspaper paragraph if it were not paid for. the presence of proper secretory nerves. As a means ofBut probably a double fee migiit command the omission of settling the question, they resorted to Heidenhain’s plan ofthe figures. Surely the senior physician should set a better investigating the action of atropine and of stinaaali of variousexample. We call upon all medical men, at home and in the strength upon the secretory activity of the gland and uponcolonies, to discourage by every means this tendency, it is a

concentration of the juice. Control experiments, madepart of the price that a professional man has to pay that he is by testing the

juice

soon after food and during fasting,not to assert himself in the public prints, either directly or showed them that the secretion of solid and of fluid con-through the medium of injudicious friends. It is out of the stituents is due to two diflerent processes, subject to two sets ofquestion that a man should be at liberty to advertise his nerves, by one of which the chemical work of the pancreaticsciei-itific opinion. If its value is not made known in the cells is governed. On injecting atropine the secretion wasquiet ways of practice it is not likely to be made evident by always checked, and in some instances completely inhibited.an advertisement.

———— They consider the evidence of the presence of proper secretoryGENERAL PRACTICE IN THE COUNTRY.

nerves to be quite irrefragable. They next proceeded toinquire whether, admitting the accuracy of Bernstein’s

THE Spectator, on the subject of doctor’s charges, says:- statement that irritation of the vagus inhibited the pan-"We are on the side of the doctors for once." Our contem- creatic secretion, this inhibitory influence is due to a directporary says a good many strong but true things in the course action, or was indirectly referable to the pain caused byof his article on the subject. His picture of practice in the stimulation of the nerve. Their experiments satisfied themcountry is not such as to attract young men whose idea of that sensory irritation of the skin was capable of inhibitinglife is to "live at home at ease," but it is not much exag-. the secretion of the pancreas.

gerated:— ———

"The doctor, unlike any other professional man, is not at THE LONDON SMALL-POX EPIDEMIC.

liberty to fix a definite price for his work, and tell his cus- AT the beginning of October last the epidemic of small-tomer either to pay his price or go without the article he

pox in London appeared to be rapidly dying out, and thewants. The positive laws of the profession, public opinion , .

- which upon this subject is quite relentless-and that small-pox patients in the hospitals of the Metropolitanfeeling of pity for suffering without which a doctor is com- Asylum Board had declined to 137. Since that date, how-paratively useless, alike make it imperative to attend any ever, the disease has again showed a steadily increasing pre-pressing case, and to charge a low price where a heavy one valence and fatality, and during the past four weeks thecannot be paid. Unless, therefore, the charge is exceedingly small-pox patients in these hospitals have rapidly risen fromlow, umiormity cannot be secured; and if it is exceedingly - .

low, able young men will not enter upon a profession so 309 to 468. The new cases admitted to these hospitals duringthankless as that of a general practitioner in the country the three weeks ending 19th inst. were 129, 124, and 129 re-There is no such life led by educated men. A general pra,c- spectively. The deaths from small-pox in the metropolis,titioner in a country district, to make £500 a year by the which had been remarkably stationary during the eighttime he is forty, must be out all day every day and half the weeks ending 12th inst., and ranged between 25 and 35,night, in all weathers, upon all roads, in an open vehicle;must abandon all notion of regularity, and almost any notion rose to ul in the last week under notice, which exceeded theof study, and must be at the beck and call of patients of highest weekly number since the middle of June last. Thewhom one-half at least will never pay him for the cost of his 51 included 30 in the Metropolitan Asylum Hospitals, andhorse’s shoes." 21 in private dwelling-houses; most of the latter occurredIn cases, by the way, where the element of poverty does under circumstances which rendered successful isolation of

not call for special consideration, we do not see why the the deceased patients practically impossible, and thus madedoctor, like any other professional man, should not be at each fatal case a probable fresh centre of infection. It ap-libcrty to fix a definite price for his work. What is more, pears from the Registrar-General’s last Weekly Return that,it would be very much for the benefit of the profession, and after distributing those occurring in hospital, the 51 fatalby no means injurious to the public, that the doctors wlio cases included 6 belonging to Pancras, 7 to Islington, 4 toare conscious of the value of their work should put a price Hackney, 7 to Stepney, 6 to Mile-end Old Town, and 5 inupon it that will make the public value it more. The public Camberwell. Of the 6 in Mile-end Old Town, 5 occurred inspends far too little over doctors. Compare what is spent by private dwelling-houses, as did 4 of the 7 in Islington, anda comfortable family on luxuries, for the most part injurious, 3 of the 5 in Camber well. Of the 51 fatal cases, 25 werewith the sum paid by it for medical opinion, which represents certified as unvaccinated and 14 as vaccinated, while in theall that is good in hygiene, in morals, and in medicine. There remaining 12 cases the medical certificates gave no infolma-is far too little independence among the leaders of the pro- tion as to vaccination. Eighteen of the fatal cases were offession. We do not mean by the leaders of the profession infants and children under five years of age, of whom 11

merely the Court physicians of London, but the best men in were certified to be unvaccinated, and 6 were "not stated"every district, be it town or country. They owe it to them- as to vaccination. Nine of the 16 cases occurring betweenselves and the profession to make themselves not quite so the ages of twenty and forty years were certified to have

139

been vaccinated in infancy, although in no case was re- might be used as a precautionary measure; but for operationsvaccination recorded. The fatality of small-pox also showed involving thermo-cauterisation it would be better to discardlast week a marked increase in the outer ring of suburban the use of ether entirely, and employ chloroform.districts, where 12 deaths resulted therefrom, including 9 in ———

West Ham, 2 in Willesden, and 1 in Croydon sulz-districts. THE VACCINATION ACT.In the 19 provincial towns furnishing weekly returns only2 deaths from small-pox were recorded during the week A SEVERE case

of small-pox has just occurred at Graves-

ending 19th inst., of which 1 occurred in Norwich, and 1 in end, which brings prominently forward what appears to beManchester ’ ,

a grave omission in the Vaccination Act.- A child, eight or nine years old, was taken ill with this

BIRMINGHAM PROVIDENT DISPENSARY. disease some three weeks since. On inquiry it was found

...’ . that he had never been vaccinated, and that an elder brotherA SERIES of regulations has been printed and widely circu- and sister were also in the same unprotected state. Appli-

lated by a committee, with the avowed object of establishing cation was at once made to the father, who certainly did notprovident dispensaries in Birmingham. It would be difficult withhold his consent, and the two were immediately vac-to conceive a set of rules better calculated to encourage im- cinated with success. At the same time he expressed hisprovidence amongst the people, and to act unjustly to the disbelief in the protective character of the operation.medical profession. All persons, whatever their incozne, are As two cases in other houses have since made their ap-to be admitted to the privileges of the dispensary on paying pearance in the town, the medical officer of health applied1s. per quarter, over fourteen, and 6d. per quarter under that to the guardians to take proceedings against this man forage. The committee, on which medical officers are not to neglect of duty in not complying with the law by submittinghave seats, are to deduct at least 25 per cent. from his children for vaccination. It was found, however, thatthe members’ payments before dividing them amongst no case could be made out against him, as the law seems tothe medical staff. The midwifery fee is fixed at fifteen affect only those who persistently refuse to obey it, and thatshillings, but members may have the attendance of a default or neglect does not come under its cognisance asmidwife on payment of 7s. 6d. It is directed tliat the punishable so long as the friends do not refuse, when themedical officers shall assist the midwife in case of difliculty unprotected individual is discovered, to have it done.if she should require them, and, in this case, shall receive On reference to the penal section this will be quite evident.from the fund set apart for expenses payment upon a scale Yet, surely, this is a great mistake. The consequencesto be decided upon by the general committee. The effect which the Act was passed to prevent have here occurred.of this regulation must necessarily be to encourage members The disease has broken out, and the parents are apparentlyto retain the midwife for the 7s. 6d. fee, with the certainty not responsible, or, at least, not punishable, though theirthat if a surgeon be required they can command his services neglect is palpable, and of the worst description.without paying him anything. He is certainly promised ____something at the discretion of the committee, that some- THE WATER-SUPPLY QUESTION.thing to be deducted out of the twenty-five per cent. re-

, .

served from the members’ payments to meet expenses. THE medical officers of health for Wandsworth in their

This scheme has been hatching nearly six months; yet last annual report, in dealing with the question of the water-no steps have been taken to submit it to the medical pro- supply of the district, complain that migration has not beenfession, though their chief local Society made an offer of co- efficiently carried out ; that the filter-beds have been im-

operation at the very commencement. A meeting to con- properly constructed, and the water has been taken con-sider the whole subject has been convened for four o’clock stantly from the Thames in whatever condition it happenednext Thursday (the 31st inst.), in Queen’s College, Birming- to be and poured on the filtering surfaces without any sub-ham. As it stands, the scheme perpetuates some of the sidence of the heavier particles ; in fact, it is alleged that,worst features of gratuitous and underpaid medical services. at times, water has been passed into the mains which hasIf it can be justly and usefully amended, the sooner that is not been in any way filtered. Again, the Vauxhall Com-done the better pany is charged with making no attempt to comply with the

- Act of Parliament, by providing a constant service of water,DANGERS OF INFLAMMABLE VOLATILE and so obviating the necessity of the cistern system. The

LIQUIDS. following suggestions are made in the report-namely, theadoption into the New Public Health Bill of a clause pro-THE following case, which recently occurred at Lyons,viding for the proper inspection and control of cisterns bytogether with some comments that it has called forth, is of an ofhcer of the local authority, and the amendment of

practical interest in these days, when ether is so largely the law regulating the power of the water examiner, byused as an anæsthetic. A young lady, eighteen years of age, giving him authority to stipulate for quantity as well aswas about to undergo an operation requiring the actual quality of the metropolitan water-supply.cautery. (The Revue de Thérapeutique from which we

quote does not give details of the operation.) Anæsthesia THE HEALTH OF HACKNEY.

was produced by ether, the vapour of which became ignitedby the heated iron, and the patient was severely burnt about A FAVOURABLE report of the public health and the sani-the face, the burn involving the tissues close to the upper tary work accomplished in the Hackney district has beenjaw. The operator, in extinguishing the flames, was himself given by Dr. Tripe, the medical officer of health. It is esti-much burnt also. A similar accident might happen if ether mated that the number of inhabitants of this district amountsbe poured from a flask near to a naked light, or if collodion to 157,250. The deaths fell from the average of 20’0 perbe applied in the same dangerous proximity, &c. The Lyon 1000 during the six years 1871 and 1876 to 196 in 1877. The

Medical, in commenting on this subject, points out that the later figure includes 173 deaths from small-lox. The births’

risk involved not only occurs during operations about the were in the proportion of 178 to 100 deaths. With regardface, in close contiguity with the ether-inhaler, but, owing to sanitary work we are told that 6191 houses were in-to the density of the vapour of this fluid, as much danger is spected, and 6257 nuisances abated, of which 1380 arose

involved in employing heated cauteries or lighted candles at from defects in drainage, 3314 from dirty or dilapidateda distance, as long as these are below the level of the in- houses, and 1563 from other causes. We should like to

haler. A guarded light, on the principle of the Davy lamp, know, however, how many among these nuisances were

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discovered in common lodging houses. These latter, being an order from the board was necessary. The chairman (Mr.under the supervision of the Scotland-yard authorities, are Rees), however, thought the people were sufficiently wise towell watched, and much is done to improve their condition; know when they required to be revaccinated without any orderbut local authorities are often remiss when dealing with from the board. " It was enough to be poisoned once in theirprivate property, which is not specially affected by Act of life. No one could tell the depth of the ignorance of theseParliament, as in the case of the common lodging-houses. doctors on the point of vaccination.

" This is rather an im-We hope that Dr. Tripe does not include the common, portant utterance from the chairman of the Board of Guard.lodging-houses of his district among the 6191 houses in- ians of one of the acknowledged sanatoria of England, andspected. ____

we recommend it to the attention of the Local Government

Board, and those medical men who are in the habit of send-BILLS BEFORE PARLIAMENT. ing patients to Dover for the good of their health.

THE following Bills, of more or less direct interest to the ———

medical professions have been laid before Parliament :- " NAVAL MEDICAL REFORM."

Bill to consolidate and amend the Acts relating to publichealth in Ireland (Sir M. Hicks-Beach) ; Bill to consolidate THE United Service Gazette professes itself surprised andand amend the law relating to factories and workshops (Mr. aggrieved by our strictures on the subject of Naval Medical

Cross) ; Bill to amend the law relating to county infirmaries Reform. We have been at once too reticent and too out-

and to the relief of the poor in Ireland (Mr. Meldon) ; Bill spoken. We do not insist with sufficient energy upon cer.

to facilitate the control and cure of habitual drunkards (Dr. tain matters of detail, while we claim too much in the demand

Cameron) ; Bill to prohibit the sale of intoxicating liquors for independent medical authority. No useful purpose is

on Sunday (Mr. Charles Wilson) ; Bill to amend the Medical likely to be served by entering into a formal discussion

Act, 1858 (Dr. Lush); Bill to make provision for the more with our lay contemporary. Suffice is to say generally thateffectual prevention of cruelty to animals (Mr. Holt); Bill we cannot admit the competence of naval men to take or

to amend the laws relating to the common sale of intoxi- refuse medical advice at their discretion ; and we againeating liquors in Ireland (Mr. O’Sullivan) ; Bill to pro-

assert that the recornmendations of medical officers should

hibit the sale of intoxicating liquors on Sundays in be "orders "carried out, under their direction, by agents re-Ireland (the O’Conor Don) ; Bill to amend the Public sponsible to the medical authority. The notion of naval

Health Act, 1875 (Mr. A. Brown); Bill to make provision officers sitting in judgment upon medical recommendations,for the purchase by the Metropolitan Board of Works of the and adopting or refusing them at will, is as absurd as would

undertakings of the several water-companies supplying water be the spectacle of a medical court of appeal deciding ques.to the metropolis, and to certain places in the neighbour- tions of seamanship. The naval service may rest assured thathood thereof, and for the supply of water by the said Board

the aim of all parties will be best secured by each depart.to the metropolis and to such places, and for other purposes ment keeping strictly within its own authority, and re-relating thereto ; also a Bill to amend the Metropolis Ma- cognising the claims of the other. .

nagement Act, 1855, the Metropolitan Building Act, 1855, ,

———

and the Acts amending the same respectively (Sir J. M’Garel THE MARSHALL HALL MEMORIAL.

Hogg) ; Bill to amend the law relating to the granting of THE time for awarding the Marshall Hall Prize-viz.,licences for the sale of spirits and other intoxicating liquors the next annual meeting of the Medico-Chirurgical Societyin Ireland (Mr. Meldon).

———— in March-is now approaching. The Council has appointed

EXHAUSTING LIBERALITY. the honorary librarian, thesecretaries, and Dr. WilliamOgle,a committee to bring suitable names before the Society for

A COMPLAINT has been raised in the daily press that the award.committees of hospitals sell stock to meet current expendi-

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ture, instead of imposing such restrictions on the extent and GOLDEN-SQUARE HOSPITAL.nature of their charity as to bring outlay within income. ALTHOUGH it is now many months since their RoyalThis is an old charge, but we are not sorry it has been re- Highnesses the Prince and Princess of Wales withdrew theirvived. A correspondent of The Times points out that patronage from the Throat Hospital, Golden-square, cir-" during the year 1877 the governors of the London Hospital culars bearing the name of His Royal Highness as patronhave been compelled to sell out £21,770 stock, besides bor- have been issued from this institution within the last fort-rowing nearly £5000, in order to meet the current expenses." night. We may expect to hear more of this.We reserve comment on this fact, but it is significant. The

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remedy suggested is a more eclectic policy of relief to the THE battle of the pavements is not yet over in the Unitedsick. How far it may be possible to reduce the expenditure States. A short time back it was thought that wood wasof a hospital by the refusal of cases it will be worth while the best material, and many miles of it were laid down into inquire at an early period. For the moment it must suffice the large cities. Now wooden pavements are condemned,to draw attention to the matter, and insist on the gravity of the material being said to rot and stink; and asphaltic or

a method of financing which consists on living on capital bituminous pavements are extolled. They are said to berather than retrench. ————

‘° I firm and elastic, noiseless, clean and dry, smooth yet rough,DOVER GUARDIANS. permanent yet easily removable, non-combustible, durable,

cheap, and readily obtainable. They also conserve the publicIT is well that those of the medical profession who are health."

in the habit of recommending a sojourn at Dover as a means ————

of recruiting health should be aware of the attitude of some DURING the progress of a football match at Paignton, onof the leading people in the borough towards such a well- the 19th inst., between the Torquay and South Devon andtried precautionary measure as vaccination. the Torquay Athletic Football Clubs (says the Totnes Times),At a meeting of the Board of Guardians, on the l8th irast., Dr. Searle, of Brixham, playing in the former team, sus-

one of the guardians (Mr. Eastes) drew attention to a bad tained a serious injury to the shoulder blade. At first thecase of small-pox in the town, and mentioned that it was bone was thought to be broken, but it turns out fortunatelyconsidered desirable by the medical man in attendance that that the injury was only a sprain. The play is described tothe people in the district should be revaccinated, in which case have been on both sides of the roughest nature.

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A REPORT of the sanitary condition of Teddington duringthe year 1877 has been issued by Dr. Giinther, medicalofficer of health. Estimating the population of Teddingtonat 5945, the annual death-rate for the period was 15’47 per1000. This is a satisfactory figure enough, but it is startlingto find it stated that of ten samples of water analysed thegreater part were found to be " polluted and unfit fordomestic purposes." In the report-which, by the way, isexceedingly brief-Dr. Gunther records the refusal of theKingston Board of Guardians to comply with a request thatcopies of the district medical officer’s weekly returns shouldbe supplied to him. The request was a most reasonable one,and it would be interesting to learn the objections which theguardians can have against furnishing information of whatdisease there may be going on amongst the poor to themedical officer of health.

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THE action taken by the Chelsea guardians with the viewof establishing a seaside institution for the reception of poorpersons in the metropolis suffering from scrofula and otherdiseases requiring sea air for their successful treatment doesnot at present seem likely to have a successful result. TheChelsea Board invited the co-operation of other guardiansin urging the desirability of such a measure on the LocalGovernment Board, but the reception accorded to the com-munication cannot be regarded as very encouraging. The

.Marylebone Board, in considering the question, appeared tothink that the enlargement of the existing sea-bathing insti-tution at Margate would do much good, but did no morethan acknowledge the receipt of the letter from Chelsea.

THE Secretary to the Sub-committee of the Royal Medicaland Chirurgical Society on the relations of Diphtheria andCroup desires us to state that the Committee are anxious toobtain the notes of any case in which the formation of falsemembrane in the air-passages has succeeded upon a definiteexposure to cold, and will be greatly indebted to any gen-tleman who will favour them with such information. Theywould also be glad of a specimen of the larynx and trachea,or of expectorated false membrane, from such a case, eitherin a fresh condition, or preserved in spirit, Miiller’s fluid, orother suitable reagent. Cases and specimens should be sentto Dr. Greenfield, secretary to the committee, 93, Wimpole-street, W., or at the Society’s Rooms, 53, Berners-street, W.

IN one respect, at all events, the inhabitants of Greenockseem to be in advance of the general population of theBritish isles-namely, in the appreciation of the need, in thepublic interest, of reporting cases of infectious disease. Dr.

Wallace, medical officer of health of the town, in his lastmonthly return, states that out of a total of 145 cases ofinfectious diseases of all sorts ascertained by the officials, asmany as 79, or 54 per cent., were reported by householdersto the authorities. Another statement in the report of anoteworthy character is that of 74 families invaded bymeasles, 44 failed to seek medical advice; of these, however,19 voluntarily made known the existence of the disease tothe health department.

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DR. THOMAS 1. ROWELL has been appointed principalmedical officer in the Straits Settlements. This appoint-ment, we understand, has been made by Lord Carnarvonsimply on the ground of the sterling qualities, professionaland other, which Dr. Rowell has given evidence of possess-ing during his practice at Singapore, where he has beenresiding for some years. ____

THE Conjoint Scheme is being expedited; another meetingwill be held at the Royal College of Surgeons on Mondaynext to further consider the report to the several medicaauthorities on the regulations for carrymg’ out the scheme.

THE decease of two distinguished French savans has justbeen announced-M. Becquerel, whose researches in electro-chemistry are well known, and who obtained the Copleymedal of the Royal Society; and M. Regnault, who, com-mencing his career as a mining engineer, afterwards obtaineda world-wide reputation as a physicist.

WE have great pleasure in stating that the Queen hasbeen pleased to appoint Alfred Hudson, M.D., to be one ofthe Physicians in Ordinary to Her Majesty in Ireland, inthe room of the late Dr. Stokes. We congratulate Dr.Hudson on the well-merited honour.

THE Metropolitan Asylums Board contemplate erectingextensive new buildings at Darenth for the reception offemale imbeciles. The proposal met with some oppositionat a late meeting of the Board, but eventually a motion .infavour of the step was carried by a majority of 13 votes.

DR. FRANCIS WARNER and Dr. GILBART SMITH are, we

understand, candidates for the newly created post of sixthassistant-physician to the London Hospital. Dr. Warnerhas held the office of Medical Registrar for the past year.

THE temporary small-pox hospital in Dodd-street, Lime-house, after having been whitewashed and thoroughly dis-infected, has been given up to the owners.

THE statue of Sir John Cordy Burrows in the BrightonPavilion grounds is to be unveiled on Thursday, Feb. 14th.

New Inventions.WORDSWORTH’S NEW PATENT "WASHABLE"

RESPIRATOR.

THE great inconvenience which arises from the difficultyof cleansing the ordinary respirator is so well known thatit serves often to prevent the recommendation of theseuseful appliances to patients requiring them. The presentrespirator, which is manufactured by Messrs. Lynch and Co.,of Aldersgate-street, is made entirely of vulcanite and bone,and can easily be taken to pieces and scrubbed thoroughlywith a nail-brush. It consists essentially of two perforatedframes, the one falling into the other, and so shaped as tomost conveniently cover the mouth. Between the two per-forated frames is enclosed a layer of cotton-wool, which canbe renewed from time to time without difficulty. Thiswool can be saturated with disinfectants, if thought neces-sary, or with any other volatile material, the inhalation ofwhich may be recommended by a physician. The thicknessand closeness of the layer of cotton-wo.ol can also be regu-lated to suit the requirements of the patient. We thinkthis exceedingly simple invention is well worthy of trial,and we have no hesitation in bringing it to the notice of theprofession. ___

"NEW ILLUMINATING LAMP."

To the Editor of THE LANCET.SIR,-Perceiving in your impression of January 5th that

Messrs. Salt, of Birmingham, have brought under yournotice a new illuminating lamp for medical purposes, we begto say that we have had the pleasure of supplying somehundreds of these useful articles to the profession since 1873.There is only one difference-namely, that our lamps are

furnished with a nickel-plated portable case, which, whendesired, not only makes a better base for the lamp, but alsoforms a reservoir to carry the oil.We have the honour to be Sir, vniir obedient servants.

J. WEISS & SON.